Hello Lactnetters!
A few weeks ago, I was posting about a mom who was being told to use
formula in an SNS even though she had plenty of breastmilk (EBM) because
her pedi felt her son was not gaining 'enough.' This pedi wanted a weight
gain of an *ounce per day* in a seven month old child.
Some background. Baby was low birthweight- about 4 weeks early. No
problems went home in 3 days. Baby's weight/length is posted below from
the mother's records (head circ included when available.)
LN=length WT=weight HC=head circumfrence
>
>8/2/96.......LN=17 1/2"......WT=5lbs 8 ozs...........................
>8/5/96.......LN=18 1/2"......WT=5lbs 7ozs.............................
>8/16/96.....LN=19".............WT=6lbs 14 ozs......HC=13 3/4"
>10/2/96.....LN=21 3/4"......WT=11lbs 8ozs.......HC=15 1/4"
>12/9/96.....LN=24".............WT=13lbs.................HC=16 1/4"
>2/4/97.......LN=24 1/2"......WT=13lbs 4ozs.......HC=16 1/2"
>2/24/97.................................WT=13lbs............................
>........
>3/3/97.......LN=25 1/4".......WT=13lbs 2 ozs......HC=16 3/4"
>3/5/97....................................WT=12lbs
>14ozs........................
>--Hospital Stay==gained 1lb 4ozs in 46 hrs on formula alone acc.to their
>scale.
>3/11/97..................................WT=13lbs 9
>ozs..........................
>3/19/97......LN=25 3/4".......WT=13lbs 11ozs.........................
>3/26/97......LN=25 3/4".......WT=13 lbs 12ozs....HC=16 7/8"
>
>Justin will be 8 months in exactly 1 week from today (3/26/97).
>
This mother sent me this today. She is very concerned as she wants to do
what is right for her child (of course.) *MY* concern is that this child's
growth curve is *better* than my own child's (a very petite 22 pound 26.5
mo old), but because i am *not* a physician, i am doubting myself a bit
here. I am leaving her post below. I believe this child is growing
adequately. He has more than doubled his birthweight, has grown more than
8 inches in length, and his head circ has been constant.
Am I wrong here? This child has been evaluated for malabsorption, for
cyctic fibrosis (he had some mucousy stools on and off), all negative.
During the hospital stay (mentioned in the weight chart) the child was
taken entirely off breastmilk, and he was weighed the next morning
**prior** to having a bowel movement.
I apologize for the length, but I hate to see this mom worry needlessly.
She is consulting with a second pedi later this week. I feel this child is
fine- he is developmentally on track.
Any and all opinions welcomed.
-------------------------------------------------------------------
>OK, here we go....I just took Justin in for another weight check (the
>office has called me everyday since Monday wondering if I am bringing him
>in--so I finally did.) He weighs an ounce more than last week. I thought
>this was just fine, partially because I am not going to stress my self out,
>and I have swithced him over to bmilk in the SNS all last week, and I have
>been reducing the number of times he gets it. He is down to 3 times a day.
> He is still sleeping with me and nursing 3-4 times a night.
>
>I will post his growth chart stuff below (I photocopied it from his chart)
>so you can see the head circumfrance and height growth as well. I would
>really appreciate your opinion on this, and any of your professional
contacts as well.
>
>Basically, my Pedi told me today that an oz a week is still not enough and
>if he doesnt "catch up" soon, he will look like a "midget" (!!!!!!?????).
>He said his head has "crossed two lines" on his precious FORMULA based
>growth chart, and that isnt good. He said that even if he is alert and
>following milestones right now, he may still have probs "and not be playing
>with a full deck" when he gets older if he doesnt get "back on track". I
>went over the charts with him pointing out that if you watch the curve, it
>is still going up. Not once has his head circumfrance dropped or
>stablized...it has always gone up. He said it didnt matter, it still wasnt
>where it was supposed to be. He said that the height (wich has also never
>dropped) and weight are also low on the chart and since all three are low
>"I need to take this very seriously and feed him more solids".
>
>He then took me out to the desk to say goodbye and proceded to tell me (in
>front of the nurse, receptionist, and 2 other parents) that I "need to get
>serious about this because he cant catch up on brain growth later".
>Needless to say, I was humiliated and treated as if I am not feeding my
>baby. I called the Pedi in the other town when I got home and she will be
>calling me tommorow when she is in the office. I am not going back to his
>office ever again. I feel so torn between knowing what is right, and
>feeling like I could be hurting Justin. I cant take much more of this
>confusion. So anyways here is his growths since birth. Sometimes they
>only took his weight, so head circumfrance and height arent always there.
[[Chart clipped to above]]
Also, I completely disagree with the recomendation to feed more SOLIDS
which are mostly lower calorie, slower digesting and would serve to
*decrease* his nursing. This child also has a probable dairy allergy
(eczema, mucous stools.)
Again, thanks for the wealth of knowledge. I'm afraid to be wrong about
this one.
Heidi
Mommy to Peyton Quinn (12-20-94)
**New Pictures!** http://www.geocities.com/Heartland/Plains/2765
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